Identification of risk areas and associated factors of unfavorable treatment outcomes in drug-resistant tuberculosis: Evidence from Rio de Janeiro, Brazil

by Heitor Levy Ferreira Praça, Juliana Cavalcanti Figueiredo, Natalia Santana Paiva, Jefferson Pereira Caldas dos Santos, Paulo Victor de Sousa Viana, Rejane Sobrino Pinheiro, Antonio Jose Leal Costa, Gerusa Gibson, Alexandre San Pedro Drug-resistant tuberculosis remains a major challenge to tuberculosis control in Brazil and worldwide. Objective To identify factors associated with unfavorable treatment outcomes and to analyze the occurrence of high-risk spatial clusters at an intra-urban scale in the municipality of Rio de Janeiro, Brazil.

Methods A retrospective cohort study of drug-resistant tuberculosis cases reported between 2015 and 2022 was conducted. Individual-level and spatial analyses were performed to identify associated factors with unfavorable outcomes and high-risk clusters.

Results Of the 972 cases analyzed, 31.6% had unfavorable outcomes, including 20.2% lost to follow-up, 4.9% with treatment failure, and 6.3% deaths. Loss to follow-up was higher among males, Black individuals, those with low education levels, individuals with AIDS, and those who used alcohol, tobacco, or illicit drugs, whereas older age and diabetes were associated with lower odds.